Cost-effectiveness analysis of ropeginterferon alfa-2b for the management of patients with polycythemia vera in Japan.

OBJECTIVE

To verify the clinical benefit of ropeginterferon alfa-2b (ropegIFN) and evaluate its cost-effectiveness compared with hydroxycarbamide or ruxolitinib for patients with polycythemia vera (PV) under the National Health Insurance (NHI) system in Japan.

METHODS

The cost-effectiveness of ropegIFN compared with hydroxycarbamide or ruxolitinib was evaluated for patients with PV requiring cytoreductive therapy (without prior cytoreductive therapy) and resistant or intolerant to hydroxycarbamide. According to previous reports, patients with PV who achieve a molecular response with a JAK2V617F allele burden < 10% tend to maintain hematologic responses even after discontinuing interferon treatment. Therefore, in these analyses, patients who achieved a molecular response with JAK2V617F burden < 10% discontinued ropegIFN treatment.

RESULTS

Compared with hydroxycarbamide, ropegIFN yielded an incremental effectiveness of 0.440 quality-adjusted life years (QALYs), indicating a higher QALY gain. The incremental costs were 128,001,730 yen, and the incremental cost-effectiveness ratio (ICER) was 291,092,030 yen/QALY. Compared with ruxolitinib, the incremental effectiveness of ropegIFN was 1.278 QALYs, while the total costs were reduced by 18,025,182 yen, which resulted in a dominant ICER.

CONCLUSIONS

These results suggest that ropegIFN may be cost-effective compared with ruxolitinib in patients with PV who are resistant or intolerant to hydroxycarbamide under the NHI system in Japan.